Acute herpes simplex gingivostomatitis and esophagitis (with video).

摘要

A 21-year-old previously healthy, immunocompetent woman presented with acute retrosternal chest pain, odynophagia, dysphagia, numerous ulcerations over the tongue and lips (A, B), and a temperature of 101.5°F. She recently had been exposed to her cousin who had documented acute Coxsackievirus infection (hand-foot-and-mouth disease). The complete blood count with differential, liver biochemical tests, chest film, and CT scan of the chest were normal. HIV serology was negative. On EGD, diffuse superficial ulcerations were seen involving the mid and distal esophagus (C, D; Video, available online at www.giejournal.org). Although viral inclusions were not seen on esophageal biopsy specimens, herpes simplex virus (HSV) was confirmed by immunochemistry staining.